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Practice
Acu. | Issue #34 | Spring 2022
Evidence base Overseas member and recovering scientist Lisa Sherman selects top abstracts of the season from the Journal of Chinese Medicine's news section to keep you up to date with the latest in acupuncture research
Lisa Sherman Overseas Member: North Carolina RESEARCH
Acupuncture durably improves prostate pain
Chinese clinicians report that acupuncture can durably improve symptoms of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). A total of 440 men with moderate to severe CP/ CPPS underwent 20 sessions of either verum acupuncture – at bilateral BL 33 zhong liao, BL 35 hui yang, BL 23 shen shu and SP 6 san yin jiao – or sham treatment (superficial needling at nearby non-acupoints) over eight weeks, with twenty-four weeks of follow-up. Treatment was considered effective if a reduction of at least six points from baseline was achieved on a validated prostatitis symptom index at weeks 8 and 32. At all assessment points, more men in the acupuncture group reported marked or moderate improvements in symptoms. At week 8, a treatment response was seen in 60.6 per cent of the acupuncture group, compared with 36.8 per cent of the sham group (adjusted odds ratio 2.6). At week 32, the proportions were 61.5 per cent in the acupuncture group and 38.3 per cent in the sham group (adjusted odds ratio 2.6). The authors noted that the sham treatment exceeded the threshold for minimal clinically important difference (a reduction of four points on the prostatitis symptom index), while pointing out that superficial needling at non-acupoints may have physiological effects. Efficacy of Acupuncture for Chronic Prostatitis/Chronic Pelvic Pain Syndrome: A Randomized Trial. Ann Intern Med. 2021 Oct;174(10):1357-66 〉 pubmed.ncbi.nlm.nih.gov/34399062/
Acupuncture improves low BDNF levels in cancer survivors with insomnia Acupuncture can increase levels of brain-derived neurotrophic factor (BDNF) in cancer survivors with insomnia and low baseline BDNF, according to a team of researchers from the USA and Canada. A randomised clinical trial compared acupuncture with cognitive behavioural therapy for insomnia (CBT-I) in 160 cancer survivors, over an eightweek period. The acupuncture protocol consisted of needling at standardised
acupuncture points classically used to treat insomnia – HT 7 shen men, SP 6 san yin jiao, DU 20 bai hui, DU 24 shen ting, auricular shen men and sympathetic – as well as supplementary points to treat comorbid symptoms (such as psychological distress, fatigue and pain). Needles remained in place for 30 minutes, and participants received a total of ten acupuncture treatments over eight weeks. Mean serum BDNF did not significantly increase in the acupuncture or CBT-I groups. However, when analysis was restricted to patients with low baseline BDNF, the acupuncture group demonstrated a significant (7.2 ng/mL) increase in mean serum BDNF, whereas the CBT-I group demonstrated a nonsignificant (2.9 ng/mL) increase. Although decreased BDNF has previously been associated with poor sleep, serum BDNF was not significantly correlated with sleep outcomes in this study. Effects of acupuncture versus cognitive behavioral therapy on brain-derived neurotrophic factor in cancer survivors with insomnia: an exploratory analysis, Acupunct Med. 2021 Dec;39(6):637-45 〉 pubmed.ncbi.nlm.nih.gov/33752446/
Placebo and nocebo suggestions don’t affect acupuncture effects in low back pain
Suggestions regarding either treatment benefits (placebo) or adverse side effects (nocebo) did not affect pain intensity reported after acupuncture treatment for chronic low back pain (CLBP). In a randomised trial conducted by Swiss and German researchers, 152 CLBP patients were randomised to receive either a regular expectation briefing or a high expectation briefing, and either a regular adverse side effect briefing or an intense adverse side effect briefing in a two-by-two factorial design. The intervention, consisting of briefing sessions and written materials, was standardised and delivered before the acupuncture treatment, with additional booster informative emails provided during the four-week, eight-session acupuncture course. All patients received the same
standardised minimal acupuncture treatment, which had been developed in a prior CLBP trial. No difference was observed between intervention groups in terms of the effect of the briefings on patients' expectations regarding the effectiveness of the acupuncture treatment. There was also no difference in pain intensity at the end of the acupuncture treatment between the groups with different expectation briefings. The adverse side effects score in the group with the intense adverse side effect briefing was estimated to be 1.31 times higher than after a regular adverse side effect briefing, but this finding was not statistically significant. Effect of Briefing on Acupuncture Treatment Outcome Expectations, Pain, and Adverse Side Effects Among Patients With Chronic Low Back Pain: A Randomized Clinical Trial. JAMA Netw Open. 2021 Sep 1;4(9):e2121418 〉 pubmed.ncbi.nlm.nih.gov/34505889/
Auricular acupressure can help prevent burnout in healthcare workers Auricular acupressure can mitigate some of the negative impact of occupational stressors on frontline healthcare workers. American researchers carried out a randomised trial in 117 staff working at a paediatric trauma centre. Participants were randomised to receive auricular acupuncture, auricular acupressure, or auricular massage delivered over a period of three weeks. Acupressure treatment (using ear seeds) was associated with a significant reduction in measures of psychological burnout and secondary traumatic stress. The authors suggest that the stress reduction offered by auricular acupressure may support healthcare workers' ability to develop caring relationships with their patients.
Effects of Acupuncture and Acupressure on Burnout in Health Care Workers: A Randomized Trial. J Trauma Nurs. 2021 Nov-Dec 01;28(6):350-62 〉 pubmed.ncbi.nlm.nih.gov/34766929/
